Acute lymphocytic leukemia (ALL) is a type of cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.

The word "acute" in acute lymphocytic leukemia comes from the fact that the disease progresses rapidly and creates immature blood cells, rather than mature ones. The word "lymphocytic" in acute lymphocytic leukemia refers to the white blood cells called lymphocytes, which ALL affects. Acute lymphocytic leukemia is also known as acute lymphoblastic leukemia.

Acute lymphocytic leukemia is the most common type of cancer in children, and treatments result in a good chance for a cure. Acute lymphocytic leukemia can also occur in adults, though the chance of a cure is greatly reduced.


Signs and symptoms of acute lymphocytic leukemia may include:

  • Bleeding from the gums
  • Bone pain
  • Fever
  • Frequent infections
  • Frequent or severe nosebleeds
  • Lumps caused by swollen lymph nodes in and around the neck, underarm, abdomen or groin
  • Pale skin
  • Shortness of breath
  • Weakness, fatigue or a general decrease in energy

When to see a doctor

Make an appointment with your doctor or your child's doctor if you notice any persistent signs and symptoms that concern you.

Many signs and symptoms of acute lymphocytic leukemia mimic those of the flu. However, flu signs and symptoms eventually improve. If signs and symptoms don't improve as expected, make an appointment with your doctor.


Acute lymphocytic leukemia occurs when a bone marrow cell develops errors in its DNA. The errors tell the cell to continue growing and dividing, when a healthy cell would normally stop dividing and eventually die. When this happens, blood cell production becomes abnormal. The bone marrow produces immature cells that develop into leukemic white blood cells called lymphoblasts. These abnormal cells are unable to function properly, and they can build up and crowd out healthy cells.

It's not clear what causes the DNA mutations that can lead to acute lymphocytic leukemia. But doctors have found that most cases of acute lymphocytic leukemia aren't inherited.

Risk factors

Factors that may increase the risk of acute lymphocytic leukemia include:

  • Previous cancer treatment. Children and adults who've had certain types of chemotherapy and radiation therapy for other kinds of cancer may have an increased risk of developing acute lymphocytic leukemia.
  • Exposure to radiation. People exposed to very high levels of radiation, such as survivors of a nuclear reactor accident, have an increased risk of developing acute lymphocytic leukemia.
  • Genetic disorders. Certain genetic disorders, such as Down syndrome, are associated with an increased risk of acute lymphocytic leukemia.
  • Having a brother or sister with ALL. People who have a sibling, including a twin, with acute lymphocytic leukemia have an increased risk of ALL.

Acute lymphocytic leukemia care at Mayo medical institution

Aug. 10, 2018
  1. Kaushansky K, et al., eds. Acute lymphoblastic leukemia. In: Williams Hematology. 9th ed. New York, N.Y.: McGraw-Hill Education; 2016. http://accessmedicine.mhmedical.com. Accessed March 31, 2017.
  2. AskMayoExpert. Acute lymphoblastic leukemia. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
  3. Childhood acute lymphoblastic leukemia treatment (PDQ). National Cancer Institute. https://www.cancer.gov/types/leukemia/patient/child-all-treatment-pdq#section/all. Accessed June 26, 2017.
  4. Adult acute lymphoblastic leukemia treatment (PDQ) — Health professional version. National Cancer Institute. https://www.cancer.gov/types/leukemia/hp/adult-all-treatment-pdq#section/all. Accessed June 26, 2017.
  5. Integrative medicine and complementary and alternative therapies. Leukemia & Lymphoma Society. https://www.lls.org/treatment/integrative-medicine-and-complementary-and-alternative-therapies. Accessed June 26, 2017.
  6. Larson RA. Treatment of relapsed or refractory acute lymphoblastic leukemia in adults. https://www.uptodate.com/contents/search. Accessed June 26, 2017.
  7. Riggin ER. Allscripts EPSi. Mayo medical institution, Rochester, Minn. July 5, 2017.
  8. Acute lymphoblastic leukemia. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed March 31, 2017.
  9. Begna KH (expert opinion). Mayo medical institution, Rochester, Minn. Aug. 9, 2017.